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Only 20% Support ACA Repeal With No Replacement

The Republican strategy of repealing the Affordable Health Care Act before devising a replacement plan has the support of only one in five Americans, a poll released Friday finds.The Kaiser Family Foundation survey also disclosed that shrinking the federal government’s involvement and spending in health care — the long-sought goal of House Speaker Paul Ryan and other Republican lawmakers — is less important to most Americans than is ensuring medical care is affordable and available. (Kaiser Health News is an editorially independent project of the foundation.)

Views split not only on partisan lines but also within the Republican Party, where nearly four in 10 think that the government should guarantee health care is available to the elderly and to low-income people, even if it means more federal involvement.

Despite the rout of Democrats in the election, which gave the GOP control of both the White House and Congress, the public’s view on the Affordable Care Act remains as divided as it has been since it was passed by President Barack Obama and congressional Democrats in 2010. Currently, 47 percent of the public wants to keep the law, which upended the way insurers do business and expanded coverage to 20 million Americans.

Opponents have not coalesced behind the GOP’s two-stage plan of repealing the law immediately and then constructing a replacement. More people (28 percent) want a replacement plan announced before repealing the existing law than the share that says the law needs to be disassembled now (20 percent).

The survey found there are opportunities on both sides of the debate to influence public opinion. Twenty-two percent of those who said they want the law to remain switched their views when told that some consumers have seen large increases in cost. The same portion changed sides after being told the country cannot afford the expense of helping people buy health insurance.

Those opposed to the law are also willing to reconsider their views. More than a third of those said they would not want the law repealed after being told that some people with preexisting health problems would no longer be able to get insurance. A quarter reversed their opinion after being told some people who got insurance because of the law would lose it if the law were repealed. President-elect Donald Trump has said he wants people with preexisting conditions protected after the law is repealed.

Democratic fears that repeal of the Affordable Care Act will damage health care are not shared by most Americans. Six in 10 people believe the quality of their care will stay the same, and only two in 10 think their care will worsen. Families where someone has a serious medical condition are more worried, but even among them, only a third anticipate the cost of their health care will suffer if the law is repealed.The poll found that the public’s most widely shared health goal is reducing the cost of care, with 67 percent of respondents calling it a top priority. Lowering the cost of prescription drugs is a top priority for 61 percent of the public, followed by addressing prescription pain killer addictions, with 45 percent listing it. Abolishing the Affordable Care Act is a top priority for 37 percent of the public, primarily among Republicans.

The poll was conducted from Dec. 13 through 19 among 1,204 adults. The margin of error is +/- 3 percentage points for the full sample.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.